Medicaid Expansion Elicits Boom in Prescriptions Filled

Prescriptions increased 19% after only 1.5 years of Medicaid expansion.

Under the Affordable Care Act (ACA), states may opt to expand their Medicaid programs to include additional lower-income individuals. The federal government is responsible for providing additional funding to ensure the states can afford covering additional enrollees.

A new study presented at the 2017 Society of General Internal Medicine Annual Meeting found that during the first 1.5 years of the ACA, prescriptions filled by Medicaid beneficiaries increased 19% in states with expanded programs compared with states with traditional programs. The authors noted substantial increases in prescriptions for chronic disease treatments and contraceptives.

"We knew the Medicaid expansion had improved access to care, but this study gives us much more detail about what that really means for patient care. Medications for conditions like diabetes and heart disease can be life-savers," said study author Benjamin Sommers, MD, PhD.

In previous studies, the authors found that Medicaid expansion has improved access to care, while also improving affordability.

In the current study, the authors analyzed pharmacy data from 2013 to 2015 and compared prescription fill rates in expansion and non-expansion states both before and after the ACA mandate took effect in 2014. Data about the type of insurance used was also gathered.

The authors found a 24% increase in diabetes medications during the first 1.5 years of Medicaid expansion, making it the drug class with the largest growth, according to the study. Prescriptions for contraceptives and cardiovascular drugs increased 22% and 21%, respectively.

There was also a 19% increase in prescriptions for drugs used to treat mental health conditions, suggesting that more patients were able to access mental health services in expanded states.

Unsurprisingly, the authors found that areas with a high uninsured rate prior to the ACA had a greater uptake of prescription drugs, according to the study.

Additionally, there were larger increases in prescription drug utilization in areas with substantial Hispanic and black populations, which suggests that Medicaid expansion may eliminate ethnic and racial disparities in accessing treatment.

Another study showed that expansion states were more likely to have a significant increase in prescriptions for buprenorphine, which is commonly used to treat opioid misuse disorder. These findings also show the need for physicians who are able to prescribe the drug.

The curre t study suggests that expansion can reduce financial barriers to care, which increases the likelihood a patient will receive treatment for opioid misuse disorder.

Overall findings have shown that Medicaid expansion may be beneficial for patient health through expanding access to affordable medication and preventive services.